Last night and this morning, I had the privilege to speak with three of the most prominent neurosurgeons in the world. One of these surgeons was Dr. Michael Lawton, the lead neurosurgeon at Barrow, who specializes in brain surgery (as opposed to spine surgery, which is what Dr. Bohl specializes in). I also got to speak with neurosurgery legend Dr. Robert Spetzler, who has contributed tremendously to the development of the entire field of neurosurgery. In fact, Dr. Spetzler regularly appears in summary articles like this one that list the most innovative neurosurgeons alive today. Finally, I got to meet Dr. Mitchel Berger, another highly prominent neurosurgeon who is the chair of the neurosurgery department at UC San Fransisco. Barrow and UC San Fransisco are two of the best neurosurgery residency programs in the world, so I'm honored to have had the opportunity to talk with the chairs of both programs, in addition to a legend in the field of neurosurgery.
I also got to see a fascinating talk by Dr. Berger on his innovative ways of performing neurosurgery. The focus of the talk was a striking technique that involves keeping the patient awake during neurosurgery! The purpose of this technique is to map regions of the brain during surgery to determine the best path to a brain tumor. During this procedure, Dr. Berger removes part of a patient's skull while they are still awake and conscious (but physically stabilized and under powerful local anesthesia, of course). He then stimulates various parts of the exposed brain using a very subtle electrode and asks the patient where they feel a tingle in their body. He uses their verbal answers to determine which parts of the brain are directly connected to each body part in his individual patient. During this procedure, he also tests language function by location. He shows the patient a continuous stream of simple images on a computer screen, which the patient is instructed to read out as they appear. As the patient is reading the images out, Dr. Berger stimulates various parts of the brain to temporarily reduce their functionality, and he carefully observes how this stimulation affects the patient's ability to identify images and speak. The mapping process allows Dr. Berger to identify regions of the brain that don't correspond with any functionality that will visibly impair the patient if they are removed, so he begins moving toward the brain tumor by making a hole in this region of the brain. He continues testing the patient continuously as he makes the hole deeper, and he changes the hole's direction if necessary if he encounters brain tissue that he discovers is connected to motor or language function. All regions of the brain are responsible for something, so some damage is inevitable in this type of surgery, but by avoiding regions that correspond to motor or language function, Dr. Berger can minimize the damage from the surgery. He can also personalize this surgery further: he once had a math teacher do problems as he was having brain surgery so that Dr. Berger could avoid the most math-focused regions of his brain. This is a fascinating and innovative method of surgery! It's amazing that brain surgery can be effectively performed on a patient who is awake. This method allows the surgeon to dynamically adjust the pathway to the patient's brain tumor based on the patient's individual brain structure, which can be determined by talking with them during surgery. Interestingly, Dr. Berger discussed that there is considerable variation between patients when it comes to brain structure, so each surgery must be performed with great care. Dr. Berger reported that he has had excellent success rates with this surgery, and he continues to train neurosurgery residents at UC San Francisco to perform this innovative type of brain surgery. This was my last day at Barrow, so after doing a bit more research in the lab, I turned in my badge to Sarah, ubered to the airport, and flew home. This was an amazing experience, and I'm tremendously grateful to all who made it possible, including Dr. Michael Bohl, Jessica Bohl, and Sarah McBryan!
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Jeremy MahoneyI'm a high school student at Maumee Valley Country Day School, and I'm currently doing a neurosurgery-focused independent study at Barrow with Dr. Michael Bohl. ArchivesCategories |